No abstract available.
Animals ; Brain* ; Pineal Gland* ; Rats*

OBJECTIVE: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. METHODS: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. RESULTS: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had 20~30% of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. CONCLUSION: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.
Bromocriptine* ; Cavernous Sinus ; Decompression ; Dopamine Agonists ; Humans ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pituitary Neoplasms ; Prolactin ; Prolactinoma* ; Prospective Studies ; Tumor Burden ; Visual Acuity ; Visual Fields

OBJECTIVES: To confirm the HAVS in workers exposed to hand-arm vibration with using the objective diagnostic methods METHODS: Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes. RESULTS: 8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases(primary Raynauds disease, secondary Raynauds disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7. 9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS. CONCLUSIONS: So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, handarm vibration acceleration level, cold provocation test, electromyography.
Acceleration ; Diagnosis ; Electromyography ; Fingers ; Hand* ; Hand-Arm Vibration Syndrome* ; Neural Conduction ; Raynaud Disease ; Skin Temperature ; Urinalysis ; Vibration*

Bullous pemphigoid (BP) is an autoimmune skin disease, which manifests as subepidermal blisters with severe itching. BP has been reported to be associated with a higher prevalence of cerebrovascular diseases in population-based studies. However, the mechanism of cerebral infarction from BP has not been elucidated yet. We hereby suggest that the missing link between BP and cerebral infarction may be eosinophil, through a case of a woman with multifocal embolic infarction.
Blister ; Cerebral Infarction* ; Cerebrovascular Disorders ; Eosinophils ; Female ; Humans ; Infarction ; Pemphigoid, Bullous* ; Prevalence ; Pruritus ; Skin Diseases ; Stroke

Tailgut cysts in retrorectal or presacral space are rare and the derivatives of the embryonic post-anal gut. It is thought to arise from vestiges of embryonic hindgut. The lesions were usually multicystic and lined by a variety of epithelial types, including ciliated columnar, mucin-secreting columnar, transitional, and squamous epithelium. Tailgut cyst has been found in men and women of various ages but is more common in women and is usually associated with middle age. They may be the source of the chronic perirectal symptoms and rarely undergo malignant change, so early diagnosis and accurate evaluation is important. Complete surgical resection should be considered because of a long term risk of malignant change. We report two cases of tailgut cyst.
Early Diagnosis ; Epithelium ; Female ; Humans ; Male ; Middle Aged

The effect of oral nicorandil were evaluated by a 9-day double-blind cross-over protocol on 16 subjects with angina pectoris referred to our cardiology clinic from June '84 through September '85. total daily doses were 15-45mg. The effects were measured by 3 seperate treadmill exercise EKG tests and symptom reviews on each patient. The following results were obtained. 1) The mean age of the patients was 57.4+/-7.2 years. These were 14 male and 2 female patients. 2) Resting heart rate on nicorandil was 73.6+/-14.0 beats/min and 70.5+/-14.0 beats/min in placebo(P<0.05). There were no significant effects of nicorandil on resting blood pressure and heart rate-blood pressure product. 3) Peak exercise heart rate was 126.4+/-22.5 beats/min on nicorandil and 121.8+/-21.4 beats/min on placebo(P<0.05). There were no significant effects of nicorandil on blood pressure after exercise and peak heart rate-blood pressure product(x10(-3)) after nocorandil was 20.2+/-5.0 and 18.9+/-4.6 on placebo(P>0.05). 4) Exercise duration was 485.8+/-107.7 sec on nicorandil and 423.3+/-101.9 sec on placebo(P<0.001). 5) The exercise duration was prolonged in 11 cases(68.7%), showed on change in 2 cases(12.5%), and shortened in 3(18.8%). 6) There were attacks of chest pain during placebo period in 2 cases, but none developed during nicorandil period. 7) Headache was noted in 2 patients, and in one of them, it was so severe as to discontinue nicorandil stydy. No other side effects were noted. In conclusion, additional therapeutic benefit can be obtained by nicorandil in patients with severe angina in spite of conventional antianginal agents already being administered.
Angina Pectoris* ; Blood Pressure ; Cardiology ; Chest Pain ; Cross-Over Studies* ; Electrocardiography ; Female ; Headache ; Heart ; Heart Rate ; Humans ; Male ; Nicorandil*

We experienced two cases of Boerhaave syndrome (spontaneous esophageal rupture). The first patient was a 62-year-old male who presented epigastric pain after several violent vomitings associated with alcohol ingestion. Diagnosis was done early and promptly in our emergency center and then definitive treatment was done only after 12hrs from onset of his symptom and he was discharged in relatively good condition 256ays after his admission. The second patient was a 44-year-old male who was transfered to our emergency center with chest pain, dyspnea and fever after vomitings associated with autobicycle accident. Diagnosis was delayed due to initial trauma oriented evaluation and incidious develpement of typical clinical findings and then he was managed conservatively but he died of multiple organ failure due to sepsis. We report these cases with literature review.
Adult ; Chest Pain ; Diagnosis ; Dyspnea ; Eating ; Emergencies ; Esophageal Perforation* ; Fever ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; Sepsis

The mutations that occur in the p53 tumor suppressor gene have been studied in various human malignant tumors. However, little is known about this gene in meningiomas. To investigate the relationship and frequency of p53 gene mutations, the p53 polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) and immunohistochemical study were performed on the 41 intracranial meningiomas (21 benign, 11 atypical, and 9 malignant). The higher the p53 protein expression rate, the poorer the histologic grade (9.5%, 72.7%, and 88.9% in benign, atypical and malignant meningioma, respectively) (p=0.000). The p53 protein expression rate was higher in recurrent meningioma (71.4%) than in nonrecurrent meningioma (10.5%) (p=0.002). PCR-SSCP method was performed in positive p53 protein immunoreactivity cases. p53 gene mutation rate was higher in the atypical (62.5%) and malignant (25%) meningiomas than in the benign meningioma (0%) (p=0.232). Also, the rate was higher in recurrent menigioma (20%) than in nonrecurrent meningioma (0%) (o=0.495). Among five to eight exons of the p53 gene, the mutation was observed on exon 7 more frequently. In conclusion, p53 immunoreactivity and p53 gene mutation are closely correlated with histologic grade and histologic atypia of intracranial meningiomas. p53 gene mutation would be considered as a useful marker to detect the progression of intracranial meningiomas.
Brain Neoplasms/pathology ; Brain Neoplasms/genetics* ; Human ; Meningioma/pathology ; Meningioma/genetics* ; Mutation* ; Neoplasm Invasiveness ; Protein p53/genetics*

OBJECTIVE: This study evaluates the effect of the specific human papillomavirus (HPV) genotype as a prognostic factor in stage I-IIA cervical cancer patients following primary surgical treatment. METHODS: The medical records of 116 cervical cancer patients treated with primary surgical treatment were reviewed. The HPV genotypes were categorized into following groups: negative and unclassified, HPV 16, HPV 18, and other high risk (HPV 31, 33, 35, 45, 51, 52, 56, and 58). RESULTS: Among the HPV genotypes, HPV 16 predominated (40.52%), followed by intermediate risk and unclassified (25%), HPV 18, 45, and 56 (17.24%) and negative (17.24%). In univariate analysis, HPV genotypes (P=0.03), parametrial spread (P=0.02), depth of invasion (DOI) (P<0.01) and lymph-vascular space invasion (P=0.02) were significantly associated with progression free survival (PFS). In multivariate analysis, HPV 18 (hazard ratio [HR], 5.2; 95% confidence interval [CI], 1.29 to 20.90; P=0.02) and > or =one half of DOI (HR, 5.4; 95% CI, 1.08 to 27.31; P=0.04) were significantly associated with PFS. HPV genotypes are not significantly associated with overall survival. CONCLUSION: HPV 18 was a poor prognostic factor for the PFS in stage I-IIA cervical cancer patients following primary surgical treatment. Careful long-term observation and regular exams are recommended for cervical cancer patients with HPV 18 compared to those with other HPV genotypes.
Disease-Free Survival ; Genotype ; Human papillomavirus 16 ; Human papillomavirus 18* ; Humans ; Medical Records ; Multivariate Analysis ; Prognosis ; Uterine Cervical Neoplasms*

Dental linear enamel hypoplasia (LEH) is probably one of the most widely used developmental stress indicators among all known skeletal stress indicators. This research examined LEH on the permanent anterior teeth of 160 human skeletal remains from the Joseon Dynasty period. The purpose of this investigation is to understand the characteristics of the developmental stresses experienced by the people of the Joseon period by analyzing the patterns of LEH incidences. The skeletal remains analyzed for this research were excavated during an archaeological investigation at a construction site in Eunpyeong-gu, Seoul, South Korea. Eunpyeong site is estimated to date from the late 15th century to the late 19th century based on the burial type and goods discovered within the graves. Of all the skeletal remains found at this site, 160 individual specimens with at least one of the permanent anterior teeth constituted the sample of the study. Information regarding each individual specimen's sex, age at death, and burial type was collected by the standardized methods. The prevalence and number of LEH by tooth type, and the number of LEH by sex, by burial type, and by age at death were analyzed. Mandibular canines were the most frequently affected teeth, maxillary canines coming next in the occurrence of LEH, and the third turned out to be the maxillary incisors. This result generally agrees with the findings from previous studies. When number of LEH by sex was compared, there was no consistent difference by sex which also agrees with the findings of previous studies. Although specimens from lime-mortar burials tended to have less number of LEH then those from earth-pit burials, a probable indication of the socioeconomic status effect on the formation of LEH, the result was not very pronounced. No obvious association between the number of LEH and age at death was found, either. Finally the results from this study were compared with those reported by other researches on LEH worldwide. Although preliminary in its level of analysis, this study is the first report of the patterns of LEH of a skeletal population of Korea. With more studies of human skeletal remains from the past, it is hoped, physical anthropology can contribute to the understanding of the past life of the Korean people.
Anthropology, Physical ; Burial ; Dental Enamel ; Dental Enamel Hypoplasia ; Humans ; Incisor ; Korea ; Prevalence ; Republic of Korea ; Sex Characteristics ; Social Class ; Tooth